Cell-free DNA predicts all-cause mortality of sepsis-induced acute kidney injury

Background Sepsis-induced acute kidney injury (S-AKI) is a common complication in critically ill patients. Therefore, reliable biomarkers for predicting S-AKI outcomes are necessary. Serum cell-free DNA (cfDNA) is a circulating extracellular DNA fragment used as a noninvasive screening tool for many diseases, including sepsis. This study aimed to investigate the prognostic value of cfDNA in S-AKI patients and its relationship with some other parameters.Methods A total of 89 S-AKI patients admitted to the intensive care unit (ICU) from June 2021 to December 2021 were enrolled in this study. The patients were categorized into the low cfDNA group (< 855 ng/ml) and high cfDNA group (≥ 855 ng/ml) and were followed up for three months. CfDNA was extracted from serum and quantified using Quant-iT PicoGreen dsDNA Reagent.Results Overall survival was significantly lower in the high cfDNA group than in the low cfDNA group (Log-Rank p = 0.012). Univariate Cox proportional hazard model showed that cfDNA was significantly associated with all-cause mortality (HR [hazard ratio] 2.505, 95% CI [95% confidence interval] 1.184-5.298, p = 0.016). Also, serum cfDNA was a significant risk factor for all-cause mortality after adjusting for covariates (HR 2.191, 95% CI 1.017-4.721, p = 0.045). Moreover, cfDNA was positively correlated with several baseline parameters, including serum creatine, aspartate aminotransferase, alanine aminotransferase, prothrombin time, and International Normalized Ratio.Conclusion High serum cfDNA level is associated with higher mortality among the S-AKI population, indicating that cfDNA is a valuable biomarker for S-AKI prognosis.

Study on the Characteristics of Coarse Feeding Tolerance of Ding'an Pigs: Phenotypic and Candidate Genes Identification

Ding'an (DA) pig, a prominent local breed in Hainan Province, exhibits notable advantages in coarse feeding tolerance and high-quality meat. To explore the potential genetic mechanism of coarse feeding tolerance in DA pigs, 60-day-old full sibling pairs of DA and DLY (Duroc-Landrace-Yorkshire) pigs were subjected to fed normal (5%) and high (10%) crude fiber diets for 56 days, respectively. The findings showed that increasing the crude fiber level had no impact on the apparent digestibility of crude fiber, intramuscular fat, and marbling scores in DA pigs, whereas these factors were significantly reduced in DLY pigs (p < 0.05). Through differential expression analysis and Weighted Gene Co-expression Network Analysis (WGCNA) of the colonic mucosal transcriptome data, 65 and 482 candidate genes with coarse feeding tolerance in DA pigs were identified, respectively. Joint analysis screened four key candidate genes, including LDHB, MLC1, LSG1, and ESM1, potentially serving as key regulated genes for coarse feeding tolerance. Functional analysis revealed that the most significant pathway enriched in differential genes associated with coarse feeding tolerance in Ding'an pigs was the signaling receptor binding. The results hold substantial significance for advancing our understanding of the genetic mechanisms governing coarse feeding tolerance in Ding'an pigs.

Differential Regulation of Male-Hormones-Related Enhancers Revealed by Chromatin Accessibility and Transcriptional Profiles in Pig Liver

Surgical castration can effectively avoid boar taint and improve pork quality by removing the synthesis of androstenone in the testis, thereby reducing its deposition in adipose tissue. The expression of genes involved in testis-derived hormone metabolism was altered following surgical castration, but the upstream regulatory factors and underlying mechanism remain unclear. In this study, we systematically profiled chromatin accessibility and transcriptional dynamics in liver tissue of castrated and intact full-sibling Yorkshire pigs. First, we identified 897 differentially expressed genes and 6864 differential accessible regions (DARs) using RNA- and ATAC-seq. By integrating the RNA- and ATAC-seq results, 227 genes were identified, and a significant positive correlation was revealed between differential gene expression and the ATAC-seq signal. We constructed a transcription factor regulatory network after motif analysis of DARs and identified a candidate transcription factor (TF) SP1 that targeted the HSD3B1 gene, which was responsible for the metabolism of androstenone. Subsequently, we annotated DARs by incorporating H3K27ac ChIP-seq data, marking 2234 typical enhancers and 245 super enhancers involved in the regulation of all testis-derived hormones. Among these, four typical enhancers associated with HSD3B1 were identified. Furthermore, an in-depth investigation was conducted on the androstenone-related enhancers, and an androstenone-related mutation was identified in a newfound candidatetypical enhancer (andEN) with dual-luciferase assays. These findings provide further insights into how enhancers function as links between phenotypic and non-coding area variations. The discovery of upstream TF and enhancers of HSD3B1 contributes to understanding the regulatory networks of androstenone metabolism and provides an important foundation for improving pork quality.

A decrease in integrin α5β1/FAK is associated with increased apoptosis of aortic smooth muscle cells in acute type a aortic dissection

BACKGROUND

Acute type A aortic dissection (AAAD) is a devastating disease. Human aortic smooth muscle cells (HASMCs) exhibit decreased proliferation and increased apoptosis, and integrin α5β1 and FAK are important proangiogenic factors involved in regulating angiogenesis. The aim of this study was to investigate the role of integrin α5β1 and FAK in patients with AAAD and the potential underlying mechanisms.

METHODS

Aortic tissue samples were obtained from 8 patients with AAAD and 4 organ donors at Zhongshan Hospital of Fudan University. The level of apoptosis in the aortic tissues was assessed by immunohistochemical (IHC) staining and terminal-deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) assays. The expression of integrin α5β1 and FAK was determined. Integrin α5β1 was found to be significantly expressed in HASMCs, and its interaction with FAK was assessed via coimmunoprecipitation (Co-IP) analysis. Proliferation and apoptosis were assessed by Cell Counting Kit-8 (CCK-8) assays and flow cytometry after integrin α5β1 deficiency.

RESULTS

The levels of integrin α5β1 and FAK were both significantly decreased in patients with AAAD. Downregulating the expression of integrin α5β1-FAK strongly increased apoptosis and decreased proliferation in HASMCs, indicating that integrin α5β1-FAK might play an important role in the development of AAAD.

CONCLUSIONS

Downregulation of integrin α5β1-FAK is associated with increased apoptosis and decreased proliferation in aortic smooth muscle cells and may be a potential therapeutic strategy for AAAD.

Metabolomics and transcriptomics of embryonic livers reveal hypoxia adaptation of Tibetan chickens

BACKGROUND

Exploring the hypoxia adaptation mechanism of Tibetan chicken is of great significance for revealing the survival law of Tibetan chicken and plateau animal husbandry production. To investigate the hypoxia adaptation of Tibetan chickens (TBCs), an integrative metabolomic-transcriptomic analysis of the liver on day 18 of embryonic development was performed. Dwarf laying chickens (DLCs), a lowland breed, were used as a control.

RESULTS

A total of 1,908 metabolites were identified in both TBCs and DLCs. Energy metabolism and amino acid metabolism related differentially regulated metabolites (DRMs) were significantly enriched under hypoxia. Important metabolic pathways including the TCA cycle and arginine and proline metabolism were screened; PCK1, SUCLA2, and CPS1 were found to be altered under hypoxic conditions. In addition, integrated analysis suggested potential differences in mitochondrial function, which may play a crucial role in the study of chicken oxygen adaptation.

CONCLUSIONS

These results suggest that hypoxia changed the gene expression and metabolic patterns of embryonic liver of TBCs compared to DLCs. Our study provides a basis for uncovering the molecular regulation mechanisms of hypoxia adaptation in TBCs with the potential application of hypoxia adaptation research for other animals living on the Qinghai-Tibet plateau, and may even contribute to the study of diseases caused by hypoxia.

Combined Transcriptomics and Metabolomics Identify Regulatory Mechanisms of Porcine Vertebral Chondrocyte Development In Vitro

Porcine body length is closely related to meat production, growth, and reproductive performance, thus playing a key role in the profitability of the pork industry. Cartilage development is critical to longitudinal elongation of individual vertebrae. This study isolated primary porcine vertebral chondrocytes (PVCs) to clarify the complex mechanisms of elongation. We used transcriptome and target energy metabolome technologies to confirm crucial genes and metabolites in primary PVCs at different differentiation stages (0, 4, 8, and 12 days). Pairwise comparisons of the four stages identified 4566 differentially expressed genes (DEGs). Time-series gene cluster and functional analyses of these DEGs revealed four clusters related to metabolic processes, cartilage development, vascular development, and cell cycle regulation. We constructed a transcriptional regulatory network determining chondrocyte maturation. The network indicated that significantly enriched transcription factor (TF) families, including zf-C2H2, homeobox, TF_bZIP, and RHD, are important in cell cycle and differentiation processes. Further, dynamic network biomarker (DNB) analysis revealed that day 4 was the tipping point for chondrocyte development, consistent with morphological and metabolic changes. We found 24 DNB DEGs, including the TFs NFATC2 and SP7. Targeted energy metabolome analysis showed that most metabolites were elevated throughout chondrocyte development; notably, 16 differentially regulated metabolites (DRMs) were increased at three time points after cell differentiation. In conclusion, integrated metabolome and transcriptome analyses highlighted the importance of amino acid biosynthesis in chondrocyte development, with coordinated regulation of DEGs and DRMs promoting PVC differentiation via glucose oxidation. These findings reveal the regulatory mechanisms underlying PVC development and provide an important theoretical reference for improving pork production.

Integrated analysis strategy of genome-wide functional gene mining reveals DKK2 gene underlying meat quality in Shaziling synthesized pigs

BACKGROUND

Shaziling pig is a well-known indigenous breed in China who has superior meat quality traits. However, the genetic mechanism and genomic evidence underlying meat quality characteristics of Shaziling pigs are still unclear. To explore and investigate the germplasm characteristics of Shaziling pigs, we totally analyzed 67 individual's whole genome sequencing data for the first time (20 Shaziling pigs [S], 20 Dabasha pigs [DBS], 11 Yorkshire pigs [Y], 10 Berkshire pigs [BKX], 5 Basha pigs [BS] and 1 Warthog).

RESULTS

A total of 2,538,577 SNPs with high quality were detected and 9 candidate genes which was specifically selected in S and shared in S to DBS were precisely mined and screened using an integrated analysis strategy of identity-by-descent (IBD) and selective sweep. Of them, dickkopf WNT signaling pathway inhibitor 2 (DKK2), the antagonist of Wnt signaling pathway, was the most promising candidate gene which was not only identified an association of palmitic acid and palmitoleic acid quantitative trait locus in PigQTLdb, but also specifically selected in S compared to other 48 Chinese local pigs of 12 populations and 39 foreign pigs of 4 populations. Subsequently, a mutation at 12,726-bp of DKK2 intron 1 (g.114874954 A > C) was identified associated with intramuscular fat content using method of PCR-RFLP in 21 different pig populations. We observed DKK2 specifically expressed in adipose tissues. Overexpression of DKK2 decreased the content of triglyceride, fatty acid synthase and expression of relevant genes of adipogenic and Wnt signaling pathway, while interference of DKK2 got contrary effect during adipogenesis differentiation of porcine preadipocytes and 3T3-L1 cells.

CONCLUSIONS

Our findings provide an analysis strategy for mining functional genes of important economic traits and provide fundamental data and molecular evidence for improving pig meat quality traits and molecular breeding.

'Gear up and get ready': Collaborative curriculum for radiographers supporting percutaneous nephrolithotomy in the operating theatre

INTRODUCTION

Newly qualified radiographers often find working in the operating theatre (OT) challenging and intimidating. These perceptions, which inhibit confidence, may hinder their effectiveness in interprofessional teamwork, which may in turn adversely affect patient outcomes. A collaborative education programme was designed, building upon the foundations of competency-based education (CBE) and simulation-based mastery learning (SBML) to examine its potential in mitigating these perceptions. The objective of this research was to assess participants' experience and level of competency after attending the curated collaborative educational programme.

METHODS

The programme was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model and comprises two teaching and learning phases: educational session and simulation. A collaborative approach was undertaken to develop an assessment checklist for the interprofessional simulation. Requirements for the simulation, such as scenario design, information and storyboard, task trainer, logistics, and learners' briefing, debrief, and feedback, were identified and assembled. The radiographers' performance was recorded using a practical skills assessment checklist and a theory assessment.

RESULTS

Twelve radiographers participated and showed improvement in their self-rating of learning objectives before and after the programme. The median (interquartile range) score achieved in the theory assessment, out of a possible of 11, was 9.00 (7.75-9.50). The median (interquartile range) score achieved in the simulation component, out of a possible of 16, was 15.00 (14.00-15.00). There was statistically significant difference in self-perceived performance in all learning objective domains.

CONCLUSION

The findings from the programme were promising. The use of simulation and an assessment checklist proved to be useful learning tools in preparing newly qualified radiographers for work in the OT.

IMPLICATIONS FOR PRACTICE

Assessment checklists are valuable tools that should be considered to facilitate teaching and learning. The use of interprofessional simulation activities can support radiographers in developing knowledge, professional skills, and clinical competency. It should be conducted in a timely manner to facilitate the introduction to role understanding and effective communication.

Polydatin alleviates sepsis‑induced acute lung injury via downregulation of Spi‑B

Sepsis-induced acute lung injury (ALI) is related to the dysregulation of inflammatory responses. Polydatin supplement was reported to exhibit anti-inflammatory effects in several diseases. The present study aimed to investigate the role of polydatin in sepsis-induced ALI. A cecum ligation and puncture (CLP)-induced mouse ALI model was established first and the pathological changes of lung tissues were assessed using hematoxylin and eosin staining. Meanwhile, to mimic sepsis-induced ALI in vitro, pulmonary microvascular endothelial cells (PMVECs) were treated with lipopolysaccharide (LPS). Pro-inflammatory cytokines levels were measured in lung tissues and PMVECs using ELISA. Reverse transcription-quantitative PCR was used to measure the mRNA levels of Spi-B in lung tissues and PMVECs. Moreover, the expression levels of Spi-B, p-PI3K, p-Akt, and p-NF-κB in lung tissues and PMVECs were determined using western blotting. The data revealed that polydatin attenuated CLP-induced lung injury and inhibited sepsis-induced inflammatory responses in mice. Furthermore, polydatin significantly inhibited the expression of Spi-B, p-PI3K, p-Akt, and p-NF-κB in lung tissues of mice subjected to CLP-induced ALI, while this phenomenon was reversed through Spi-B overexpression. Consistently, the anti-inflammatory effect of polydatin was abolished by Spi-B overexpression. Taken together, the current findings revealed that polydatin alleviated sepsis-induced ALI via the downregulation of Spi-B.

Measurement of the 2νββ Decay Rate and Spectral Shape of ^{100}Mo from the CUPID-Mo Experiment

Neutrinoless double beta decay (0νββ) is a yet unobserved nuclear process that would demonstrate Lepton number violation, a clear evidence of beyond standard model physics. The process two neutrino double beta decay (2νββ) is allowed by the standard model and has been measured in numerous experiments. In this Letter, we report a measurement of 2νββ decay half-life of ^{100}Mo to the ground state of ^{100}Ru of [7.07±0.02(stat)±0.11(syst)]×10^{18}  yr by the CUPID-Mo experiment. With a relative precision of ±1.6% this is the most precise measurement to date of a 2νββ decay rate in ^{100}Mo. In addition, we constrain higher-order corrections to the spectral shape, which provides complementary nuclear structure information. We report a novel measurement of the shape factor ξ_{3,1}=0.45±0.03(stat)±0.05(syst) based on a constraint on the ratio of higher-order terms from theory, which can be reliably calculated. This is compared to theoretical predictions for different nuclear models. We also extract the first value for the effective axial vector coupling constant obtained from a spectral shape study of 2νββ decay.

Mapping and validation of quantitative trait loci associated with dorsal aleurone thickness in rice (Oryza sativa)

KEY MESSAGE

Mapping of QTLs for dorsal aleurone thickness (DAT) was performed using chromosome segment substitution lines in rice. Three QTLs, qDAT3.1, qDAT3.2, and qDAT7.1, were detected in multiple environments. As a specified endosperm cell type, the aleurone has an abundance of various nutrients. Increasing the number of aleurone layers is a practicable way of developing highly nutritious cereals. Identifying genes that can increase aleurone thickness is useful for the breeding of aleurone traits to improve the nutritional and health values of rice. Here, we found that iodine staining could efficiently distinguish the aleurone layers, which revealed great variation of the aleurone thickness in rice, especially at the dorsal side of the seed. Therefore, we used a population of chromosome segmental substitution lines (CSSLs) derived from Koshihikari and Nona Bokra for quantitative trait locus (QTL) analysis of the dorsal aleurone thickness (DAT). Three QTLs, qDAT3.1, qDAT3.2, and qDAT7.1, were detected in multiple seasons. Among these, qDAT3.2 colocalizes with Hd6 and Hd16, two QTLs previously identified to regulate the heading date of Koshihikari, explaining the negative correlation between the DAT and days to heading (DTH) in rice. We also provide evidence that early-heading ensures the filling of rice seed under a relatively high temperature to promote aleurone thickening. qDAT7.1, the most stable QTL expressed in different environments, functions independently from heading date. Although Nona Bokra has a lower DAT, its qDAT7.1 allele significantly increased DAT in rice, which was further validated using two near-isogenic lines (NILs). These findings pave the way for further gene cloning of aleurone-related QTLs and may aid the development of highly nutritious rice.

A198 THE LONG-TERM IMPACT OF ENVIRONMENTAL EXPOSURES ON HOST HEALTH AND THE RISK FACTORS OF CROHN'S DISEASE

Background

Several environmental factors are associated with Crohn’s disease (CD) in large case-control studies; however, it is not clear how these factors maybe be influenced by age of exposure and if they are related to alterations in pre-disease biological markers of CD risk.

Purpose

To investigate the association between environmental factors in different age groups with future risk of CD onset and assess their relation to other pre-disease biomarkers.

Method

We used an environmental risk assessment questionnaire (ERA) to collect information from healthy first-degree relatives(FDR) of CD enrolled in the CCC-GEM project. ERA was a multi-item questionnaire querying 69 questions under 7 section headings: background, cultural/ethnic, smoking history, medical history, family history, environmental history and pet history. For the environmental and pet sections, current and historical (<1, 2-4, 5-15 years old) data was captured at the time of recruitment. We used Cox proportional hazard models to identify exposures associated with future CD onset. Next, we used regression models to identify the relationship of exposures with biological factors associated with CD risk previously identified by our group i.e.: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR) with LMR≥0.025 defined as abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) with FCP≥100µg/g; and iii) fecal microbiome composition and diversity using 16S rDNA sequencing. Two-sided p<0.05 (or false discovery rate corrected p<0.05) were considered significant.

Result(s)

A total of 4289 FDRs were recruited, 47% were male, median recruitment age was 17.0 years[6-35]. After a median follow-up of 5.6-years (IQR=3.42-8.67), 86 FDRs developed CD. Living with a dog between age 5-15 (Hazard Ratio (HR)=0.61; 95% confidence interval (CI)=0.39-0.95), and a large family size (>3) in the first year of life (HR=0.41; 95% CI=0.22-0.89) were protective against CD onset. Conversely, having a bird at time of survey (HR=2.84; CI=1.37-5.90), and having a sibling with CD (HR=2.07; 95% CI=1.18-3.63) were risk factors for CD onset. We found that owning a dog between age of 5-15 (Odd Ratio(OR)=0.77, 95% CI=0.65-0.90) was significantly associated with LMR, nine taxa bacterial and higher chao1 diversity index. Having a bird at time of survey was significantly associated with FCP (OR=2.04, 95% CI=1.33-3.11). There was no association between large family size and having a CD sibling with gut microbiome, FCP or LMR.

Conclusion(s)

The study identified four environmental factors associated with future development of CD. Among them, exposure to dogs during early life was protective against CD onset and might be explained by its association with normal gut permeability and microbiome. We also identified that having a bird at recruitment increased risk of CD onset which might be mediated by an increase in subclinical inflammation.

Submitted on behalf of the CCC-GEM consortium

Disclosure of Interest

None Declared

A39 HEALTHY FIRST-DEGREE RELATIVES FROM MULTIPLEX FAMILIES VERSUS SIMPLEX HARBOR A HIGHER RISK OF DEVELOPING CROHN'S DISEASE AND ARE ASSOCIATED WITH SUBCLINICAL INFLAMMATION AND ALTERED MICROBIOME COMPOSITION

Background

Healthy individuals within families with multiple affected members (multiplex families) with Crohn’s disease (CD) have a notably high risk of developing CD. No large prospective pre-disease cohort has assessed differences in preclinical intestinal inflammation, permeability, fecal microbiome, and genetics in healthy at-risk subjects from multiplex families.

Purpose

We aimed to assess differences in subclinical gut inflammation, genetic risk, gut barrier function, and fecal microbiota composition between first-degree relatives (FDRs) from families with 2 or more affected members (multiplex) and families with only one affected member (simplex). Also, we aimed to assess the risk of future CD onset in subjects from multiplex versus simplex families.

Method

We utilized the GEM Project cohort of healthy FDRs of CD patients. Subclinical gut inflammation was assessed using fecal calprotectin (FCP) at recruitment. Gut barrier function was assessed using the lactulose-to-mannitol ratio (LMR). For assessment of the CD-related genetic risk, CD-polygenic risk scores (CD-PRS) were calculated. Microbiome composition was assessed by sequencing fecal 16S ribosomal RNA. Generalized estimating equations logistic regression and LEfSe (PMID: 21702898) were used to assess the associations between multiplex status and different outcomes. A Cox proportional hazards model was used to assess time-related risk of future onset of CD.

Result(s)

4385 subjects were included. Median age was 17 [IQR 12-24] years, 52.9% were female, 69.4% were siblings and 30.6% were offspring. 4052 (92.4%) and 333 (7.6 %) were simplex and multiplex subjects, respectively. After adjusting for age, sex, family size, and relation to proband, multiplex status was significantly associated with higher baseline FCP (p=0.038), but was not associated with either baseline LMR or CD-PRS (p=0.19 and p=0.33, respectively).

We found no significant differences in alpha diversity (Shannon index) (p=0.57) between simplex and multiplex subjects. Beta diversity analysis assessed by the Bray-Curtis dissimilarity index did not reveal significant differences (R2=3e-04, p=0.607). The genera Eisenbergiella, Eggerthellaceae uncultured, and Morganella, were significantly more abundant in multiplex subjects, whereas Lachnospira, Sutterella, Lachnospiraceae_NK4A136_group, and Lachnospiraceae_UCG_004 less abundant.

The risk of CD onset was significantly higher in multiplex subjects. In multivariable analysis, multiplex status at recruitment was associated with increased risk of CD onset (adjusted HR 3.41, 95% CI 1.70-6.87, p=0.00055), after adjusting for demographics, FCP, LMR, and CD-PRS.

Conclusion(s)

Multiplex status compared to simplex is associated with a 3.4-fold increased risk of CD onset, a higher FCP, and fecal bacterial composition. A comprehensive assessment of environmental factors that increase CD risk in multiplex families remains to be elucidated in future studies.

Disclosure of Interest

None Declared

A218 ASSOCIATIONS BETWEEN ADHERENCE TO LITERATURE-DERIVED DIETARY INDICES AND PRE-DISEASE BIOMARKERS: IMPLICATIONS FOR CROHN’S DISEASE PREVENTION

Background

The incidence of Crohn’s disease (CD) is increasing globally, indicating a significant environmental influence such as diet. A plethora of dietary adherence (DA) patterns exist in the literature: the Mediterranean Diet (MD), Empirical Dietary Inflammatory Pattern (EDIP), Specific Carbohydrate Diet (SCD), and low Fermentable Oligosaccharide, Disaccharide, Monosaccharide, or Polyol diet (FODMAP) are all potential candidates to maintain a reduced level of inflammation, improving gastrointestinal function. Contrary, the Westernized diet (WD) is generally reported as a diet promoting inflammation in humans.

Purpose

To determine if DA to literature-derived dietary indices in a cohort of first-degree relatives (FDRs) of CD patients can modulate pre-disease biomarkers.

Method

We used food frequency questionnaire (FFQ) data from 2,696 healthy FDR subjects of the Crohn’s Colitis Canada- Genes, Environment, Microbial (CCC-GEM) project. We rederived each of the following scores using our FFQ data, utilizing originally described methods for the MD, EDIP, SCD, low FODMAP, and WD to obtain DA. Each diet was correlated pairwise via Kendall’s Tau.

We fit multivariable regression models to identify the association of DA (top quintile vs remaining) and: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR), LMR≥0.03 defined abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) measured with BÜHLMANN fCAL® ELISA, FCP≥250µg/g defined inflammation; and iii) fecal microbiome richness and composition using 16S rRNA sequencing. Two-sided p<0.05 for primary and q<0.05 for secondary analysis defined significance.

Result(s)

There were positive correlations between the MD, SCD, and low FODMAP, these diets negatively correlated with the WD. The EDIP negatively correlated with the SCD and low FODMAP, did not correlate with the MD, and positively correlated with the WD. No diet was associated with abnormal LMR or FCP. Only the SCD was associated with increased microbial richness (q=0.03). All diets were associated with microbial genera: the MD (n=18 taxa, (2.0^-7<q-values< 0.04), EDIP (n=9, [2.8^-4-0.05]), SCD (n=13, [3.7^-11-0.05]), low FODMAP (n=14, [1.3^-7-0.05]), and WD (n=1, [0.03]).

Conclusion(s)

This study shows that literature-derived dietary indices correlate generally with each other, yet none were not associated with abnormal LMR or FCP. However, we found that diet can impact microbiome richness and composition. Thus, it is tempting to speculate that diet is a possible intervention capable of maintain microbiome homeostasis to reduce future risk of CD.

Submitted on behalf of the CCC-GEM consortium.

Funding

Crohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III

The Leona M. and Harry B. Helmsley Charitable Trust

Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Disease

Disclosure of Interest

None Declared

A238 BILE ACID COMPOSITION AND DIETARY FAT: IMPLICATIONS FOR CROHN’S DISEASE IN A COHORT OF HEALTHY FIRST-DEGREE RELATIVES

Background

Crohn’s disease (CD) is a chronic relapsing inflammatory disease of the gastrointestinal tract. The etiology of CD may arise from complex interactions including host genetics, diet, and the intestinal microbiome. Increased consumption of saturated fats, characteristic of the Western diet, is a known risk factor for CD. Dietary fat (DF) is absorbed by the host through the release of primary bile acids (PBAs) and bio-transformed by the microbiome into secondary bile acids (SBAs). Altogether, bile acids (BAs) can act as signaling molecules involved in host immune regulation and potentially in CD onset.

Purpose

To investigate the relationship between CD risk, BAs, and DF, and evaluate the predictive performance of CD onset of these factors by developing machine learning models.

Method

We used samples healthy first-degree relatives (FDRs) recruited as part of the Crohn’s Colitis Canada- Genes, Environment, Microbial (GEM) project. Those who developed CD (n=87) were matched 1:4 by age, sex, follow-up time, and geographic location with control FDRs remaining healthy (n=347).

Serum, urine, and stool BA were measured using ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy. DF types were derived from food frequency questionnaire data. We used conditional logistic regressions to identify associations between CD onset, BAs (n=93), and DFs (n=9). We further explored the relationships of significant CD-related BAs and DF via Generalized Estimation Equations. Finally, we used a tree-based machine-learning algorithm (XGBoost) with 5-fold cross-validation to assess the prediction performance of CD onset using BA from all sources as well as DF. Two-sided p<0.05 was considered significant.

Result(s)

In total, 10 of 93 BAs, and two of nine DFs were significantly associated with increased odds of CD onset (p<0.05). Additionally, five BAs were significantly associated with DF (p<0.05). Serum-derived BAs had the best predictive performance for CD, with a mean AUC of 0.70 [95% CI: 0.63;0.76], followed by stool derived BAs with a mean AUC= 0.65 [0.55;0.75], and followed by urine derived Bas with a mean AUC= 0.57 [0.48;0.66]. Lastly DF was not a predictive marker of CD onset with a mean AUC= 0.50 [0.41;0.60].

Conclusion(s)

This study suggests that BAs are associated with the pathogenesis of CD and the effects may be influenced by DF. Serum-derived BAs may be able to better predict the risk of CD than other stool or urine derived BA, while DF is not directly implicated in CD risk.

Submitted on behalf of the CCC-GEM consortium.

Funding

Crohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III

The Leona M. and Harry B. Helmsley Charitable Trust

Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases

The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD)

Jingcheng Shao is the recipient of a Data Science Institute Summer Undergraduate Data Science award

Disclosure of Interest

None Declared

[Bushen Huoxue Fang improves recurrent miscarriage in mice by down-regulating the JAK2/STAT3 pathway]

OBJECTIVE

To investigate the efficacy of Bushen Huoxue Fang (BSHXF, a traditional Chinese medicine formula) for improving recurrent spontaneous abortion (RSA) in mice and the role of tyrosine kinase (JAK2) and transcriptional activator (STAT3) signaling pathway in its therapeutic mechanism.

METHODS

Female CBA/J mice were caged with male DBA/2 mice to establish RSA mouse models, which were randomly divided into model group, dydrogesterone group and BSHXF group, with the female mice caged with male BALB/c mice as the control group (n=6). From the first day of pregnancy, the mice were subjected to daily intragastric administration of BSHXF, dydrogesterone, or distilled water (in control and model groups) for 12 days. After the treatments, serum levels of antithrombin III (AT-III), activated protein C (APC), tissue plasminogen activator (t-PA), progesterone, human chorionic gonadotropin (HCG), and estradiol (E2) were detected in each group using ELISA. HE staining was used to observe the morphological changes of the endometrium of the mice. Western blotting was performed to determine the expressions of p-JAK2, p-Stat3 and Bcl-2 in the placenta of the mice.

RESULTS

Compared with the control mice, the mouse models of RSA showed a significantly increased embryo loss rate with decreased serum levels of AT-III, T-PA, progesterone, APC and HCG, increased placental expressions of p-JAK2, p-STAT3 and Bax, and decreased expression of Bcl-2 (P < 0.05). Treatments with BSHXF and dydrogesterone both increased serum levels of AT-III, t-PA and HCG in the mouse models; Serum APC level was significantly reduced in BSHXF group and serum progesterone level was significantly increased in dydrogesterone group (P < 0.05).

CONCLUSION

BSHXF can improve the prethrombotic state and inhibit cell apoptosis by downregulating the JAK2/STAT3 pathway to increase the pregnancy rate in mouse models of RSA.

Novel Haplotype in the HHEX Gene Promoter Associated with Body Length in Pigs

The screening of important candidate genes and the identification of genetic markers are important for molecular selection in the pig industry. The hematopoietically expressed homeobox (HHEX) gene plays an important role in embryonic development and organogenesis; however, the genetic variation and expression pattern of the porcine HHEX gene remains to be clarified. In this study, semiquantitative RT-PCR and immunohistochemistry results showed the specific expression of the HHEX gene in porcine cartilage tissues. A novel haplotype consisting of two SNPs rs80901185 (T > C) and rs80934526 (A > G) was detected in the promoter region of the HHEX gene. The expression of the HHEX gene was significantly higher in Yorkshire pigs (TA haplotype) than in Wuzhishan pigs (CG haplotype), and a population analysis showed that this haplotype was significantly associated with body length. An analysis subsequently revealed that the -586 to -1 bp region of the HHEX gene promoter showed the highest activity. Furthermore, we found that the activity of the TA haplotype was significantly higher than that of the CG haplotype by changing the potential binding of transcription factors YY1 and HDAC2. In summary, we conclude that the porcine HHEX gene may contribute to the breeding of pigs for body length traits.

Association between Sarcopenia and Cognitive Trajectories among Middle-Aged and Older Adults in China: A Nationally Representative Cohort Study

OBJECTIVES

The relationship between sarcopenia and cognitive function has been extensively studied, but is usually explored at a single time point. We used repeatedly measured cognitive data to examine the relationship between sarcopenia and cognitive trajectories over time among middle-aged and older Chinese adults.

DESIGN

A nationally representative cohort study.

SETTING AND PARTICIPANTS

Data were from three waves (2011, 2013 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 8963 participants with complete baseline data (wave 1) and at least two cognitive function tests (waves 1-3) were enrolled in this study.

MEASUREMENTS

Sarcopenia was diagnosed at baseline (wave 1). The wave 1-3 data were used to analyze cognitive trajectories over time by constructing a latent class trajectory model (LCTM). Logistic regression model was used to analyze the association between sarcopenia and cognitive trajectories.

RESULTS

Among 8693 participants, we identified two trajectories of cognitive function development, including a persistent low trajectory (n= 4856, 55.86%) and a persistent high trajectory (n= 3837, 44.14%). Sarcopenia was associated with persistently low cognitive trajectory of global cognitive (OR: 1.248, 95%CI: 1.046-1.490) after adjustment for other covariates. This association was still observed when stratified by age, gender, educational level, marital status, social activity, smoking status and drinking status. Mediation analysis showed that body mass index (BMI) mediated efficacy accounting for 42.32% of the relationship.

CONCLUSIONS

Our study showed two trajectory groups of global cognitive function. Sarcopenia was associated with a persistent low trajectory over time and BMI mediated the relationship between sarcopenia and cognitive trajectories among middle-aged and older Chinese adults.

[Efficacy of endoscopic treatment oncolorectal laterally spreading tumor and risk factors of delayed bleeding after operation]

Objective: To evaluate the endoscopic treatment efficacy of colorectal laterally spreading tumor (LST) and analyze the risk factors for delayed post-polypectomy bleeding (DPPB). Methods: Between January 2015 and December 2020, patients underwent colorectal endoscopic submucosal dissection (ESD) or hybrid ESD were recruited from the Second Affiliated Hospital of Zhejiang University. Complete resection rate, perforation rate, bleeding rate, operation time and lesion adhesion were compared between the ESD and hybrid ESD groups. Patients were divided into bleeding and non-bleeding groups based on the presence of DPPB. Multivariate logistic regression analysis was used to analyze the risk factors of DPPB. Results: A total of 665 patients with colorectal LST were enrolled, including 376 males and 289 females, with an average age of (57.4±0.4) years. There were 471 cases underwent ESD and 194 cases underwent hybridized ESD. There were no significant differences in gender, age, history of smoking and drinking, and prevalence of hypertension between the two groups (all P>0.05). Likewise, the rate of lesion adhesion (4.2% vs 7.7%, P=0.067), lesion complete resection (96.8% vs 93.8%, P=0.418), perforation (0.6% vs 1.0%, P=0.594), delayed bleeding (2.8% vs 2.1%, P=0.605) were not statistically significant between the two groups. Seventeen patients (2.6%) developed DPPB after endoscopic treatment. Multivariate logistic regression analysis showed that the lesion was in the rectum (OR=3.594, 95%CI: 1.237-10.443, P=0.019) and the diameter of the lesion>2 cm (OR=3.776, 95%CI: 1.411-10.106, P=0.008) were risk factors for DPPB. Conclusions: Both ESD and hybrid ESD are successful treatments for colorectal LST. Colorectal LST lesion site and lesion size>2 cm are risk factors of DPPB.

Toxicity and risk assessment of nine pesticides on nontarget natural predator Harmonia axyridis (Coleoptera: Coccinellidae)

BACKGROUND

Harmonia axyridis (Coleoptera: Coccinellidae) is a beneficial predatory arthropod in the agricultural ecosystem. For the success and development of integrated pest management strategies, it is essential to assess the toxicity risks of commonly used pesticides to nontarget arthropods.

RESULTS

The glass tube residue method was used to determine the risk of nine pesticides to H. axyridis after second-instar exposure. To assess the potential risk of the selected pesticides, the pre-adult LR₅₀ values were calculated by the hazard quotient (HQ) method. The LR₅₀ (application rate causing 50% mortality) values of imidacloprid, dinotefuran, thiamethoxam, acetamiprid, bifenthrin, and dimethoate were 0.44, 0.82, 0.10, 0.05, 0.04, and 0.21 g a.i. ha^-1 , respectively, showing unacceptable risk to H. axyridis after exposure to in and off field. However, emamectin benzoate and two fungicides, tebuconazole and myclobutanil, posed a low risk to H. axyridis and their HQ values were less than the trigger value of 5.

CONCLUSIONS

The four neonicotinoid insecticides (imidacloprid, dinotefuran, thiamethoxam, and acetamiprid), pyrethroid bifenthrin, and organophosphorus dimethoate showed a high risk to H. axyridis. Emamectin benzoate, tebuconazole, and myclobutanil showed a low risk to H. axyridis under both exposure scenarios. The results provide critical scientific evidence to guide future regulation of pesticide management practices and protection of nontarget arthropods like H. axyridis. © 2022 Society of Chemical Industry.

Effect of SLC16A1 on Hepatic Glucose Metabolism in Newborn and Post-Weaned Holstein Bulls

Background: Patterns of liver energy metabolism significantly differ from birth to adult in cattle undergoing change of rumen rumination. However, the genes involve in hepatic energy metabolism during bovine development and how regulate are still unclear. Methods: In this study, 0-day-old newborn calves (0W) and 9-week-old weaned calves (9W) were used to investigate differences in liver glucose metabolism at these stages of calf development. We did this primarily through the quantitation of energy metabolism indicators, then sequencing the liver transcriptome for each group of claves. Results: The transcriptome results showed 979 differentially expressed genes (DEGs), enriched in animal organ development, catabolic process, transmembrane transport. SLC16A1 involved in that and was locked to investigate. We explored the effects of SLC16A1 on glucose and lactate flux in vitro. We identified and verified its target, miR-22-3p, through bioinformatics and luciferase reporter assays. Moreover, this study found that miR-22-3p decreased cell activity by negatively regulating the SLC16A1. Importantly, our result showed the insulin-induced SLC16A1 mRNA expression decreased, regulated by promoter activity rather than miR-22-3p. Conclusions: Our study illustrates the role of SLC16A1 in the liver mediated metabolism of developing calves. These data enrich our knowledge of the regulatory mechanisms of liver mediated glucose metabolism in developing cattle.

[Clinical effect and influencing factors of focused ultrasound ablation surgery combined with suction curettage for the treatment of mass-type cesarean scar pregnancy]

Objective: To investigate the clinical effect of focused ultrasound ablation surgery (FUAS) combined with suction curettage for mass-type cesarean scar pregnancy (CSP) and to analyze the influencing factors of vaginal bleeding and readmission. Methods: From January 2014 to December 2020, 88 patients with mass-type CSP were treated by FUAS combined with suction curettage in the Third Xiangya Hospital of Central South University. The clinical results and the influencing factors of bleeding and readmission for mass-type CSP were analyzed. Results: All the patients underwent one time FUAS treatment successfully. Immediately after FUAS treatment, color Doppler ultrasound showed obvious necrosis and no perfusion area in all lesions, and the blood flow in the mass-type CSP tissue significantly decreased. The median volume of blood loss in the procedure was 20 ml (range: 5-950 ml). Thirteen patients (15%, 13/88) had vaginal bleeding≥200 ml, and 15 patients (17%, 15/88) were hospitalized again. The average time for menstruation recovery was (28±8) days (range: 18-66 days). The average time needed for serum human chorionic gonadotropin-beta subunit to return to normal levels was (22±6) days (range: 7-59 days). The risk of large vaginal bleeding of patients were related to the blood supply of the mass (OR=5.280, 95%CI: 1.335-20.858, P=0.018) and the largest diameter of the mass (OR=1.060, 95%CI: 1.010-1.120, P=0.030). The risk of readmission were related to the largest diameter of the mass (OR=1.055, 95%CI: 1.005-1.108, P=0.030) and the depth of the uterus cavity (OR=1.583, 95%CI: 1.015-2.471, P=0.043). No serious complications such as intestinal and nerve injury occurred during and after FUAS treatment. Conclusions: FUAS combined with suction curettage is safe and effective in treating patients with mass-type CSP through this preliminary study. The volume of vaginal bleeding are associated with the blood supply of the mass and the largest diameter of the mass, the risk of readmission are related to the largest diameter of the mass and the depth of the uterus cavity.

The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut

Background

Secondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the underlying mechanism of infection.

Methods

In this prospective, observational case–control study, a total of 34 septic patients, 33 non-septic intensive care unit (ICU) patients and 10 healthy individuals serving as controls were enrolled. Three hundred and twelve fecal samples were collected and subjected to 16S rRNA gene amplicon sequencing. Metagenome sequencing was performed to identify the homology between dominant CRKP or VRE in the intestine and pathogens isolated from secondary infectious sites. C57/BL mice were established as pseudo germ-free animal model by pretreatment with broad-spectrum antibiotics for two weeks.

Results

The abundance and diversity of the gut microbiota in septic patients was drastically decreased one week after ICU admission, potentially leading to the enrichment of antibiotic-resistant bacteria, such as CRKP. Furthermore, secondary bloodstream and abdominal infections caused by CRKP or VRE in septic patients occurred after intestinal colonization with the predominant bacterial species. Genomic analysis showed that bacteria isolated from secondary infection had high homology with the corresponding predominant intestinal opportunistic pathogens. In addition, animal model experiments validated the hypothesis that the administration of antibiotics caused the enrichment of CRKP and VRE among the intestinal microbiota, increasing the likelihood of permeation of other tissues and potentially causing subsequent systemic infection in pseudo germ-free mice.

Conclusion

Our study indicated that the pathogens causing secondary infection in septic patients might originate from the intestinal colonization of pathogens following broad-spectrum antibiotic treatment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13054-022-03943-z.

Integration of Long Non-Coding RNA and mRNA Profiling Reveals the Mechanisms of Different Dietary NFC/NDF Ratios Induced Rumen Development in Calves

The aim of the present study was to explore the effects of dietary non-fibrous carbohydrate to neutral detergent fiber (NFC/NDF) ratios on rumen development of calves, and to investigate the mechanisms by integrating of lncRNA and mRNA profiling. Forty-five weaned Charolais hybrid calves [body weight = 94.38 ± 2.50 kg; age = 70 ± 2.69 d] were randomly assigned to 1 of 3 treatment groups with different dietary NFC/NDF ratios: 1.10 (H group), 0.94 (M group) and 0.60 (L group), respectively. The ventral sac of the rumen was sampled for morphological observation and transcriptional sequencing. The average daily gain of calves in the high NFC/NDF ratio group was significantly higher than that in other groups (p < 0.05). Papillae width was largest in high NFC/NDF ratio group calves (p < 0.05). Identified differentially expressed genes that were significantly enriched in pathways closely related to rumen epithelial development included focal adhesion, Wingless-int signaling pathway, thyroid hormone signaling pathway, regulation of actin cytoskeleton and cGMP-PKG signaling pathway. The lncRNA-mRNA network included XLOC_068691 and MOAB, XLOC_023657 and DKK2, XLOC_064331 and PPP1R12A which we interpret to mean they have important regulatory roles in calve rumen development. These findings will serve as a theoretical basis for further analysis of the molecular genetic mechanism of dietary factors affecting rumen development in calves.

[An area under curve-based nomogram to predicts vancomycin-associated nephrotoxicity in critically ill patients: a retrospective cohort study]

Objective: To develop an area under curve (AUC)-based nomogram to predict vancomycin-associated nephrotoxicity in critically ill patients. Methods: This retrospective cohort study included adult patients treated with vancomycin in the intensive care unit at a tertiary teaching hospital from January 2015 to December 2017. Baseline clinical characteristics before vancomycin treatment and pharmacokinetic parameters were collected to establish a prediction model of nephrotoxicity. Univariate analysis was used to screen variables, and multivariate logistic regression analysis was used to establish the prediction model and nomogram. Results: A total of 159 patients met the inclusion criteria, sixty-four were included in the final analysis. Sixteen patients (25%, 16/64) developed vancomycin-associated nephrotoxicity. The following variables were incorporated into the prediction model: vancomycin AUC, estimated glomerular filtration rate (GFR), and combined nephrotoxic drugs. The following equation was established to calculate the probability of nephrotoxicity: logit (P)=-4.83+0.009×AUC-2.87×1 (if GFR>60 ml/min)+2.53×1 (if number of combined nephrotoxic drugs≥2). A nomogram was generated based on the equation. The receiver-operating characteristic curve demonstrated that the AUC of the prediction model was 0.927 (95%CI 0.851-1.000). The cut-off value of the probability of nephrotoxicity was 26.48%. The sensitivity and specificity were 87.5% and 87.5% respectively. Conclusion: The incidence of vancomycin-associated nephrotoxicity is high. The AUC-based nomogram can effectively predict vancomycin-associated nephrotoxicity in critically ill patients.

A238 ALTERED GUT MICROBIOME COMPOSITION AND FUNCTION ARE ASSOCIATED WITH GUT BARRIER DYSFUNCTION IN HEALTHY RELATIVES OF CROHN’S DISEASE PATIENTS

Background

The gut microbiome may play a role in gut barrier homeostasis including epithelial barrier function, but data are scarce and limited to animal studies

Aims

To assess if alterations in gut microbiome are associated with gut barrier function

Methods

We utilized the Genetic Environmental Microbial (CCC GEM) cohort of healthy first-degree relatives (FDRs) of Crohn’s disease (CD) patients. Gut barrier function was assessed using the ratio of urinary fractional excretion of lactulose to mannitol (LMR). Stool bacterial DNA was extracted and sequenced for the V4 hypervariable region of the 16S rRNA gene using MiSeq and processed using QIIME2. Microbial functions were imputed using PICRUSt2. The cohort was divided into a North American discovery cohort (n=2,472) and non-North American external validation cohort (n=655). LMR>0.025 was defined as abnormal. LMR-microbiome associations were assessed using multivariable regression model and Random Forest (RF) classifier algorithm. q<0.05 was considered significant when multiple tests were performed

Results

The median age of the entire cohort was 17.0 years [IQR 12.0; 24.0], 52.6% were females and 25.4% had LMR>0.025. In the discovery cohort, subjects with LMR>0.025 had markedly reduced alpha diversity (Chao1 index, estimate= -0.0037, p=4.0e-04) and altered beta diversity (Bray-Curtis dissimilarity index, PERMANOVA: pseudo-F statistic = 2.99, p=1.0e-03). We identified eight bacterial genera and 52 microbial pathways associated with LMR>0.025 (q<0.05). Four genera (decreased Adlercreutzia [odds ratio(OR)=0.74, 95% confidence interval (CI) 0.6–0.91], Clostridia-UCG-014 [OR=0.71, 95%CI 0.59–0.86], and Clostridium-sensu-stricto-1 [OR=0.75, 95%CI 0.61–0.92] and increased Colidextribacter [OR=1.65, 95%CI 1.2–2.26]) and eight pathways (including decreased biosynthesis of glutamate [OR=0.4, 95%CI 0.21–0.74], tryptophan [OR=0.06, 95%CI 0.01–0.27] and threonine [OR=0.038, 95%CI 0.003–0.41]) were replicated. Bacterial community composition was associated with gut barrier homeostasis as defined by the RF analysis (p= 1.4e-6)

Conclusions

Gut microbiome community and pathways are associated with gut barrier function. These findings may identify potential microbial targets to modulate barrier function

Submitted on behalf of the CCC-GEM Consortium

Funding Agencies

CCC, CIHRCrohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III; The Leona M. and Harry B. Helmsley Charitable Trust; Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases

A157 DEFINITIONS OF MEDITERRANEAN DIET INCONSISTENTLY ASSOCIATE WITH MARKERS OF GUT BARRIER FUNCTION OR SUBCLINICAL INFLAMMATION IN A POPULATION-BASED COHORT

Background

The Mediterranean Diet (MD) is proposed to reduce the risk of Crohn’s disease (CD) onset in cohort studies, with inconsistent results. This inconsistency may be due to heterogeneity in defining MD scores. Additionally, relationships between MD compliance and intestinal permeability or sub-clinical inflammation are not defined.

Aims

We examined correlations between different MD scores, and determined associations between MD compliance and intestinal permeability or subclinical inflammation in a cohort of first degree relatives of CD patients.

Methods

We used food frequency questionnaire data from 2,112 subjects of the Crohn’s Colitis Canada- Genes, Environment, Microbial (CCC-GEM) project. We obtained 12 MD definitions from the literature and calculated daily percent compliance, we further compared MD scores via pairwise correlations (Kendall’s Tau). We measured intestinal permeability via urinary fractional excretion ratio of lactulose to mannitol (LMR) (LMR≥0.03 defined abnormal), and subclinical inflammation via fecal calprotectin (FCP) measured with BÜHLMANN fCAL® ELISA (FCP≥250 defined abnormal). We fit multivariable regression models between MD compliance and abnormal LMR and FCP, respectively. Two-sided p&lt;0.05 defined significance.

Results

There was large variation in cross-correlations among MD scores, from nil (t=0.0, p=0.54) to highly significant (t=0.97, p&lt;2.2e-16). Associations of MD compliance and abnormal LMR or FCP were in both directions of effect, largely non-significant. Of the 12 MD scores, none associated with abnormal LMR, while 4 associated with abnormal FCP-Odds Ratios =1.22, 1.23, 1.24, and 1.30; p=0.02, 0.02, 0.01, and 0.009, and 95% Confidence Intervals = [1.03,1.45], [1.04,1.45], [1.05,1.47], and [1.07,1.59] respectively. No diet remained significant after correcting for multiple testing.

Conclusions

Currently MD definitions vary widely. Despite discrepancies, we expected consistent directions of effect for MD compliance on LMR or FCP. The largely non-significant associations between MDs suggest limitations in definition, interpretation, and relation to biological outcomes.

Submitted on behalf of the CCC-GEM consortium.

Funding Agencies

CIHRCrohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III;The Leona M. and Harry B. Helmsley Charitable Trust; Justine Timpano is a recipient of a fellowship award from Mount Sinai Hospital; Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases

Diagnosis of sepsis with inflammatory biomarkers, cytokines, endothelial functional markers from SIRS patients

BACKGROUND

Sepsis is a life-threatening illness with a challenging diagnosis. Rapid detection is the key to successful treatment of sepsis. To investigate diagnostic value, the plasma protein profiles of inflammatory biomarkers, cytokines, and endothelial functional markers were compared between healthy controls, SIRS, and septic patients.

METHODS

The plasma protein profiles were performed by Luminex Assay in a cohort of 50 SIRS patients, 82 septic patients and 25 healthy controls. Fourteen plasma proteins were analyzed in the same cohort: IL-1β, IL-6, IL-8, IL-10, CCL-2, VEGF, VEGF-C, VEGFR2, CD62E, CD62P, MFG-E8, ICAM-1, TFPI, Urokinase.

RESULT

IL-2R, IL-6, IL-8, IL-10, CCL-2, ICAM-1, and Urokinase were significantly higher in sepsis patients than SIRS patients. VEGF, IL-1β, CD62E, CD62P, MFG-E8, and TFPI have no statistical difference. VEGF-C, VEGFR2 were significantly different in SIRS patients than sepsis patients. Urokinase, ICAM-1, and VEGFR2 were significantly different between sepsis group and SIRS group. The AUCs of Urokinase, ICAM-1, and VEGFR2 and the combination for the diagnosis of sepsis were 0.650, 0.688, 0.643, and 0.741, respectively.

CONCLUSIONS

Most patients have the higher level of several cytokines and developed endothelial cell injury in the initial phase of sepsis, Urokinase, ICAM-1, and VEGFR2 may be useful to evaluate severity and prognosis of sepsis patients.

Theoretical and experimental insights into the mechanisms of C6/C6 PFPiA degradation by dielectric barrier discharge plasma

As an emerging alternative legacy perfluoroalkyl substance, C6/C6 PFPiA (perfluoroalkyl phosphinic acids) has been detected in aquatic environments and causes potential risks to human health. The degradation mechanisms of C6/C6 PFPiA in a dielectric barrier discharge (DBD) plasma system were explored using validated experimental data and density functional theory (DFT) calculations. Approximately 94.5% of C6/C6 PFPiA was degraded by plasma treatment within 15 min at 18 kV. A relatively higher discharge voltage and alkaline conditions favored its degradation. C6/C6 PFPiA degradation was attributed to attacks of •OH, •O₂^-, and ¹O₂. Besides PFHxPA and C2 -C6 shorter-chain perfluorocarboxylic acids, several other major intermediates including C4/C6 PFPiA, C4/C4 PFPiA, and C3/C3 PFPiA were identified. According to DFT calculations, the potential energy surface was proposed for possible reactions during C6/C6 PFPiA degradation in the discharge plasma system. Integrating the identified intermediates and DFT results, C6/C6 PFPiA degradation was deduced to occur by stepwise losing CF₂, free radical polymerization, and C-C bond cleavage. Furthermore, the DBD plasma treatment process decreased the toxicity of C6/C6 PFPiA to some extent. This study provides a comprehensive understanding of C6/C6 PFPiA degradation by plasma advanced oxidation.

GPR174 mRNA Acts as a Novel Prognostic Biomarker for Patients With Sepsis via Regulating the Inflammatory Response

Previous studies indicated that G-protein coupled receptor 174 (GPR174) is involved in the dysregulated immune response of sepsis, however, the clinical value and effects of GPR174 in septic patients are still unknown. This study is aimed to evaluate the potential value of GPR174 as a prognostic biomarker for sepsis and explore the pathological function of GPR174 in cecal ligation and puncture (CLP)-induced septic mice. In this prospective longitudinal study, the expressions of peripheral GPR174 mRNA were measured in 101 septic patients, 104 non-septic ICU controls, and 46 healthy volunteers at Day 1, 7 after ICU (Intensive Care Unit) admission, respectively. Then, the clinical values of GPR174 for the diagnosis, severity assessment, and prognosis of sepsis were analyzed. Moreover, the expressions of GPR174 mRNA in CLP-induced septic mice were detected, and Gpr174-knockout (KO) mice were used to explore its effects on inflammation. The results showed that the levels of GPR174 mRNA were significantly decreased in septic patients compared with non-septic ICU and healthy controls. In addition, the expressions of GPR174 mRNA were correlated with the lymphocyte (Lym) counts, C-reactive protein (CRP), and APACHE II and SOFA scores. The levels of GPR174 mRNA at Day 7 had a high AUC in predicting the death of sepsis (0.83). Further, we divided the septic patients into the higher and lower GPR174 mRNA expression groups by the ROC cut-off point, and the lower group was significantly associated with poor survival rate (P = 0.00139). Similarly, the expressions of peripheral Gpr174 mRNA in CLP-induced septic mice were also significantly decreased, and recovered after 72 h. Intriguingly, Gpr174-deficient could successfully improve the outcome with less multi-organ damage, which was mainly due to an increased level of IL-10, and decreased levels of IL-1β and TNF-α. Further, RNA-seq showed that Gpr174 deficiency significantly induced a phenotypic shift toward multiple immune response pathways in septic mice. In summary, our results indicated that the expressions of GPR174 mRNA were associated with the severity of sepsis, suggesting that GPR174 could be a potential prognosis biomarker for sepsis. In addition, GPR174 plays an important role in the development of sepsis by regulating the inflammatory response.

Spatiotemporal distribution of human brucellosis in Inner Mongolia, China, in 2010-2015, and influencing factors

Human brucellosis is caused by Brucella species and remains a major burden in both human and domesticated animal populations, especially in Inner Mongolia, China. The aims of this study were to analyze the spatiotemporal trends in human brucellosis in Inner Mongolia during 2010 to 2015, to explore the factors affecting the incidence of brucellosis. The results showed that the annual incidence was 29.68–77.67 per 100,000, and peaked from March to June. The majority of human brucellosis was male farmers and herdsmen, aged 40–59 years. The high-risk areas were mainly Xilin Gol League and Hulunbeier City. The incidence of human brucellosis in Inner Mongolia decreased during 2010 to 2015, although the middle and eastern regions were still high-risk areas. The regions with larger number of sheep and cattle, lower GDP per capita, less number of hospital beds, higher wind speed, lower mean temperature more likely to become high-risk areas of human brucellosis.

Macrophage-derived implantable vaccine prevents postsurgical tumor recurrence

Immunotherapy emerges as a potential therapeutic strategy against tumor relapse. However, immunosuppressive tumor microenvironment poses an obstacle to immunotherapy. Of particular note is that macrophages are abundant in solid tumors and tumor-associated macrophages (TAMs) are mainly anti-inflammatory and protumoral. Therefore, re-educating TAMs will be critical for improving the antitumor efficacy of immunotherapy. Herein we engineered a macrophage-derived implantable vaccine for suppressing postsurgical tumor relapse. The vaccine comprised hybrid cytomembranes from macrophages/tumor cells and an immunoadjuvant, cytosinephosphate-guanosine oligodeoxynucleotides (CpG ODNs). The vaccine was further embedded into a calcium alginate hydrogel for tissue-localized delivery. Results show that the vaccine could induce the shift from anti-inflammatory M2-like TAMs to proinflammatory M1-like macrophage. Moreover, the vaccine stimulated systemic immunity by facilitating dendritic cells (DCs) maturation and memory T (T EM) cell activation, forming a self-replenishing circulation in tumor microenvironment. Consequently, the vaccine could prevent the postsurgical tumor relapse at both the primary and distant tumor sites. In addition, the lung metastasis was also reduced by the vaccine implantation in mice. The multifunctional vaccine prepared from biomacromolecule and nature-derived material provides a biocompatible and versatile tool for re-educating TAMs and preventing postsurgical tumor recurrence.

Identification of soluble thrombomodulin and tissue plasminogen activator-inhibitor complex as biomarkers for prognosis and early evaluation of septic shock and sepsis-induced disseminated intravascular coagulation

BACKGROUND

Endothelium injury and coagulation dysfunction play an important role in the pathogenesis of sepsis. Soluble thrombomodulin (sTM), tissue plasminogen activator-inhibitor complex (t-PAIC), thrombin-antithrombin complex (TAT) and α2-plasmin inhibitor-plasmin complex (PIC) are biomarkers of endothelium injury and coagulation dysfunction. This study aimed to explore the prognostic values and diagnostic performance for septic shock and sepsis-induced disseminated intravascular coagulation (DIC) of endothelial biomarkers.

METHODS

We conducted an observational study on patients with sepsis admitted to intensive care unit (ICU) at a teaching hospital from January 2016 to December 2018. Levels of sTM, t-PAIC, TAT and PIC were measured at admission day and day 5-7 after admission and detected by qualitative chemiluminescence enzyme immunoassay performed on HISCL automated analyzers.

RESULTS

A total of 179 septic patients and 125 non-septic ICU controls were enrolled. The level of sTM was higher in septic patients compared to ICU controls (OR =1.093, 95% CI: 1.045-1.151, P<0.001). Moreover, higher levels of sTM and t-PAIC were independent predictors of poor 60-day prognosis for septic patients (HR =1.012, 95% CI: 1.003-1.022, P=0.012; HR =1.014, P=0.009). Level of sTM was also higher in patients with septic shock as revealed by multivariate analysis (OR =1.049, 95% CI: 1.020-1.078, P=0.001), as well as in patients with sepsis-induced DIC (OR =1.109, 95% CI: 1.065-1.158, P<0.001). sTM was considered as a sensitive biomarker for the early prediction of septic shock and sepsis-induced DIC, with AUC up to 0.765 (0.687-0.842) and 0.864 (0.794-0.935) of receiver operating characteristic curve.

CONCLUSIONS

Most patients developed coagulopathy which was closely linked to endothelial injury in initial phase of sepsis, which was demonstrated by abnormalities in endothelial biomarkers and their strong association with poor 60-day prognosis and development of septic shock and sepsis-induced DIC.

New Limit for Neutrinoless Double-Beta Decay of ^{100}Mo from the CUPID-Mo Experiment

The CUPID-Mo experiment at the Laboratoire Souterrain de Modane (France) is a demonstrator for CUPID, the next-generation ton-scale bolometric 0νββ experiment. It consists of a 4.2 kg array of 20 enriched Li_{2}^{100}MoO_{4} scintillating bolometers to search for the lepton-number-violating process of 0νββ decay in ^{100}Mo. With more than one year of operation (^{100}Mo exposure of 1.17  kg×yr for physics data), no event in the region of interest and, hence, no evidence for 0νββ is observed. We report a new limit on the half-life of 0νββ decay in ^{100}Mo of T_{1/2}>1.5×10^{24}  yr at 90% C.I. The limit corresponds to an effective Majorana neutrino mass ⟨m_{ββ}⟩<(0.31-0.54)  eV, dependent on the nuclear matrix element in the light Majorana neutrino exchange interpretation.

The Protective Effect of Aspirin against Myocardial Hypertrophy in Rats

The protective effect of aspirin against myocardial hypertrophy (MH) was studied. Model rats of pressure overload MH were prepared by abdominal aortic coarctation. Rats were randomly divided into the sham group (n = 9), MH model group (n = 9), and MH+aspirin group (n = 9), which was, respectively, divided into the 4-week group and 8-week group according to the time of intragastric administration. Arterial blood pressure and left ventricular mass index (LVMI) were measured. Changes in myocardial tissue structure were observed by HE staining, Masson staining, and reticular fiber staining. Cardiomyocyte apoptosis was detected by TUNEL assay. The levels of TNF-α, IL-10, TXA2, and PGI2 in myocardium and plasma were detected by ELISA. The arterial blood pressure in the MH model group was significantly higher than that in the 4- and 8-week sham groups, but that in the MH+aspirin group was significantly lower than that in the MH model group. At 4 and 8 weeks, the LVWI in the MH model group was significantly higher than that in the sham group, but it was significantly reduced after aspirin treatment. The myocardial cell hypertrophy was obvious, collagen fibers were proliferated, and reticular fibers were reduced in the 4- and 8-week MH model groups. Compared with the MH model groups, myocardial cells in the MH+aspirin groups were significantly reduced, the collagen fiber content was significantly reduced, and the reticular fiber content was increased. The apoptotic cardiomyocytes in the 4- and 8-week MH model groups were obviously increased. The apoptosis of myocardial cells in the MH+aspirin groups was obviously decreased. The TNF-α levels in the myocardial tissue of the 4- and 8-week MH model groups were significantly increased, while those of the MH+aspirin groups were significantly decreased. There was no significant change in the IL-10 level or PGI2 level at 4 weeks. At 8 weeks, the PGI2 level was significantly decreased in the MH model group while significantly increased in the MH+aspirin group. The TXA2 levels were significantly increased in the 4- and 8-week MH model groups and those in the 4- and 8-week MH+aspirin groups were significantly lower. Aspirin has an anti-inflammatory effect, can effectively reduce the expression of inflammatory factors, inhibit myocardial apoptosis, and has a certain protective effect against MH.

Design, synthesis and biological evaluation of benz-fused five-membered heterocyclic compounds as tubulin polymerization inhibitors with anticancer activities

A series of benz-fused five-membered heterocyclic compounds were designed and synthesized as novel tubulin inhibitors targeting the colchicine binding site. Among them, compound 4d displayed the highest antiproliferative activity against four cancer cell lines with an IC₅₀ value of 4.9 μM in B16-F10 cells. Compound 4d effectively inhibited tubulin polymerization in vitro (IC₅₀ of 13.1 μM). Further, 4d induced cell cycle arrest in G2/M phase. Finally, 4d inhibited the migration of cancer cells in a dose-dependent manner. In summary, these results suggest that compound 4d represents a new class of tubulin inhibitors deserving further investigation.

Discovery of novel CA-4 analogs as dual inhibitors of tubulin polymerization and PD-1/PD-L1 interaction for cancer treatment

A series of novel CA-4 analogs as dual inhibitors of tubulin polymerization and PD-1/PD-L1 were designed, synthesized and bio-evaluated. Among them, compound TP5 exhibited strongest inhibitory effects against five cancer cell lines with an IC50 value of 800 nM in HepG2 cells. In addition, mechanism studies revealed that TP5 could effectively inhibit tubulin polymerization, suppress HepG2 cells migration and colony formation, and cause cell arrest at G2/M phase and induce apoptosis. Furthermore, TP5 exhibited moderate anti-PD-1/PD-L1 activity with IC50 values of 48.76 μM in a homogenous time-resolved fluorescence (HTRF) assay. In vivo efficacy studies indicated that TP5 could significantly suppress tumor growth in an immune checkpoint humanized mouse model with a Tumor Growth Suppression (TGI) of 57.9% at 100 mg/kg without causing significant toxicity. Moreover, TP5 did not cause in vivo cardiotoxicity in BALB/c mice. These results suggest that the novel CA-4 analogs may serve as a starting point for developing more potent dual inhibitors of tubulin polymerization and PD-1/PD-L1.

Shufeng Jiedu capsules protect rats against LPS-induced acute lung injury via activating NRF2-associated antioxidant pathway

Shufeng Jiedu capsule (SFJDC) is a traditional Chinese medicine, which has been used for the treatment of respiratory infections for more than thirty years in Hunan (China). SFJDC protected rats against LPS-induced acute lung injury (ALI); however, the molecular mechanisms underlying the therapeutic effects of SFJDC remain unclear. Therefore, this study aimed at analyzing the major anti-inflammatory compounds of SFJDC and exploring the underlying molecular mechanisms. SFJDC dissolved in water was fingerprinted by UPLC/Q-TOF. Inflammation response was assessed by histopathological examination and ELISA assay. Arterial blood gases were also analyzed to evaluate the function of rat lungs. The expression levels of Kelch-like ECH-associating protein 1 (Keap1), Nrf2, heme oxygenase-1 (HO1), Cullin 3 (CUL3) and NQO1 were analyzed by Western blotting. Results indicated that SFJDC alleviated inflammation response by reducing the level of inflammatory cytokines, and upregulation of glutathione-S-transferase (GST) and superoxide dismutase (SOD) in lung tissues. Furthermore, SFJDC suppressed LPS-induced upregulation of Keap 1 and CUL3 in rat lungs. The expression of NRF2 HO1 and NQO1 were further upregulated by SFJDC in the presence of LPS, indicating that SFJDC might activate the NRF2-associated antioxidant pathway. In conclusion, SFJDC treatment may protect the rat lungs from LPS by alleviating the inflammation response via NRF2-associated antioxidant pathway.

The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study

Background

Hypertension is a worldwide public health problem. We sought to examine the interactive associations among sodium intake, alcohol consumption and hypertension among older adult residents of Inner Mongolia in northern China.

Methods

This cross-sectional study used data from the National Survey for Nutrition and Adult Chronic Disease in Inner Mongolia. The prevalence of hypertension was age standardized by the direct method. Sodium intake and alcohol consumption were estimated using a weighing method and 24-h recalls on 3 consecutive days. Hypertension was either self-reported or field-measured. Participants were categorized into six subgroups according to combinations of sodium intake status and drinking level. Logistic regression was used to determine the interactive effect of sodium intake and drinking on hypertension.

Results

Of the 820 older adults who participated in this study, 523 (63.80%, age-standardized rate = 62.33%) had been diagnosed with hypertension. The mean sodium intake was 4.88 g. Sodium intake and drinking excessively were both independently related to higher risk of hypertension. A formal test for a multiplicative interaction between sodium intake and drinking revealed a significant interaction (p = 0.042), and the multivariable-adjusted odds ratio (95% CI) for the interaction was 1.1 (1.0–1.3). After adjusting for confounders, compared with moderate sodium intake and no drinking group, the risk of hypertension was highest among those with both excessive sodium intake and excessive alcohol consumption, with an odds ratio of 3.6 (95% CI: 1.7–7.9).

Conclusions

The study highlights the interactive effect of sodium intake and alcohol consumption on hypertension. Primary health care providers should pay special attention to older adults with hypertension—especially those with an unhealthy diet including both excessive sodium and excessive alcohol intake. These findings are applicable for older adults in Inner Mongolia and worldwide.

The Application of Virtual Simulated Experiment in the Theoretical Teaching (ABO Blood Grouping) for Physiology

Objective: To explore the effect on students’ independent learning capacity through the usage of virtual simulated experiment ((here after referred to as VSE) in the theoretical teaching for Physiology. Methods: This research is conducted in Inner Mongolia Medical University. Experimental group: students majored in Forensic Medicine, Class 1, 2019. Self-study teaching mode is applied in the content of blood type and ABO blood grouping with VSE in the theoretical course. Control group: students majored in Psychiatry, Class 1, 2019. Traditional teaching mode is applied to the same content. The effects of these two modes are assessed through test performance and questionnaire. Results: Students adopted self-study mode with VSE are superior to those employed traditional teaching mode in test performance. Questionnaires answered by experimental group show that students are satisfied with self-study mode through the application of VSE. Meanwhile, their independent learning capacity has been improved. Conclusion: The application of self-study teaching mode with VSE can enhance students’ learning effect and contribute to the improvement of self-study ability. It should be applied further in medical theory teaching.

Recent Advances in the Development of PD-L1 Modulators: Degraders, Downregulators, and Covalent Inhibitors

Therapeutic interference of the programmed cell death protein 1(PD-1)/immunosuppressive programmed cell death ligand 1 (PD-L1) signaling pathway by monoclonal antibodies has achieved spectacular success for treating various tumors. However, the development of small molecule inhibitors of PD-1/PD-L1 has lagged far behind due to the challenge of targeting the highly hydrophobic and relatively flat binding interface, despite the benefits small molecule can bring over therapeutic antibodies. This technical challenge provokes the adoption of different strategies in searching for small, medium-sized, and large molecule modulators (e.g., degraders, downregulators, and covalent inhibitors) of the PD-1/PD-L1 protein-protein interaction. In this review article, we discuss latest advances in the development of PD-L1 modulators, with a focus on degraders, downregulators, and covalent inhibitors.

Plant protein diet-induced hypoimmunity by affecting the spiral valve intestinal microbiota and bile acid enterohepatic circulation in Amur sturgeon (Acipenser schrenckii)

An 8-week growth trial was conducted to study enterohepatic recirculation of bile acid metabolism and the intestinal microbiota of Amur sturgeon (Acipenser schrenckii) fed with three diets, including 540 g/kg, 270 g/kg or 0 g/kg fishmeal, which was correspondingly replaced by a plant protein blend (named P0, P50 and P100, respectively). The diets were designed to be isonitrogenous, isoenergetic and essential nutrients balanced. With rising levels of dietary plant protein, disruption of the spiral valve intestinal microbiota and more morbidity with liver disease were observed in the P100 group, although there were no haematological abnormalities observed. An obvious bile acids enterohepatic circulation disorder was found with phenotypes of increased liver bile acids compensatory synthesis, and reduced expression of bile acid receptors (FXR and TGR5), which induced BA accumulative toxicity. Accompanied by increased oxidative stress, it further induced hepatic lesions and hypoimmunity, which were non-negligible reasons for the high mortality and low utilization ability of plant protein by Amur sturgeon.

[Comparative analysis on amenable mortality with main non-communicable diseases in urban and rural areas in China, 2010 and 2017]

Objective: To analyze the composition and differences of amenable mortality in urban and rural areas in China, 2010 and 2017. Methods: With the national mortality rates in 2010 and 2017 calculated by the National Bureau of Statistics and the National Health Commission as the reference, the underreporting rate from diseases was adjusted in combination with the cause-of-death surveillance data published by the Chinese Center for Disease Control and Prevention, and Center for Health Statistics and Information, National Health Commission. Age-standardized mortality was calculated by using a direct method based on the population census in 2010. Differences of the mortality in two years were compared, and the proportion of amenable mortality of different diseases in the total amenable mortality was calculated. Results: In 2010 and 2017, the age-standardized total mortality of non-communicable diseases was 536.4/100 000 and 493.6/100 000, respectively. The age-standardized amenable mortality rates were 107.6/100 000 and 96.0/100 000, respectively. Compared with 2010, the mortality of four major non-communicable diseases declined in 2017. The fastest declined amenable mortality was in with an average annual growth rate of -5.6%, followed by chronic respiratory diseases (-2.5%). Among the 11 subdivided non-communicable diseases, the age-standardized mortality of hypertension, chronic rheumatic heart disease and cerebrovascular disease declined, with an average annual growth rate of -6.7%, -5.8% and -3.0%, respectively. The proportion of amenable mortality from cerebrovascular disease was the highest among the 11 subdivided non-communicable diseases in 2010 and 2017, from 52.4% to 47.2%, followed by ischemic heart disease with an increase from 27.4% to 34.5%. Conclusion: Compared with that in 2010, the amenable mortality of non-communicable chronic diseases in urban and rural areas in China declined in 2017, of which cerebrovascular disease and ischemic heart disease account for more than 80%.

Characteristics and roles of severe acute respiratory syndrome coronavirus 2-specific antibodies in patients with different severities of coronavirus 19

The diagnosis of coronavirus 19 (COVID-19) relies mainly upon viral nucleic acid detection, but false negatives can lead to missed diagnosis and misdiagnosis; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody detection is convenient, safe and highly sensitive. Immunoglobulin (Ig)M and IgG are commonly used to serologically diagnose COVID-19; however, the role of IgA is not well known. We aimed to quantify the levels of SARS-CoV-2-specific IgM, IgA and IgG antibodies, identify changes in them based on COVID-19 severity, and establish the significance of combined antibody detection. COVID-19 patients, divided into a severe and critical group and a moderate group, and non-COVID-19 patients with respiratory disease were included in this study. A chemiluminescence method was used to detect the levels of SARS-CoV-2-specific IgM, IgA and IgG in the blood samples from the three groups. Epidemiological characteristics, symptoms, blood test results and other data were recorded for all patients. Compared to the traditional IgM-IgG combined antibodies, IgA-IgG combined antibodies are more effective for diagnosing COVID-19. During the disease process, IgA appeared first and disappeared last. All three antibodies had significantly higher levels in COVID-19 patients than in non-COVID-19 patients. IgA and IgG were also higher for severe and critical disease than for moderate disease. All antibodies were at or near low levels at the time of tracheal extubation in critical patients. Detection of SARS-CoV-2-specific combined IgA-IgG antibodies is advantageous in diagnosing COVID-19. IgA detection is suitable during early and late stages of the disease. IgA and IgG levels correspond to disease severity.

Influence of exosome-derived miR-21on chemotherapy resistance of esophageal cancer

OBJECTIVE

To explore the influence of exosome-derived micro-ribonucleic acid (miR)-21 on chemotherapy resistance of esophageal cancer and its mechanism.

MATERIALS AND METHODS

Human esophageal cancer TE-1 and Eca109/DDP cell lines and human normal esophageal Het-1A cells were cultured, and the exosomes were extracted from cells. After miR-21 was inhibited with an inhibitor and overexpressed with miRNA mimics combined with cisplatin, the cell viability was detected via cell counting kit-8 (CCK-8), the interaction between miR-21 and programmed cell death 4 (PDCD4) was detected via dual-luciferase reporter gene assay, and the changes in the protein level were detected via Western blotting.

RESULTS

The expression level of exosome-derived miR-21 in esophageal cancer cells was higher than that in normal esophageal cells, and it was the highest in cisplatin-resistant esophageal cancer cells. After treatment with cisplatin, miR-21 overexpression significantly reduced the invasion ability of esophageal cancer cells. After miR-21 overexpression, the sensitivity of esophageal cancer cells to cisplatin was lowered. MiR-21 interacted with the 3'-untranslated region (UTR) of PDCD4. Moreover, the miR-21 overexpression significantly down-regulated the mRNA and protein levels of PDCD4 in cells.

CONCLUSIONS

MiR-21 affects the sensitivity of esophageal cancer to cisplatin through targeting PDCD4.

Prevalence, knowledge and education level associated with secondhand smoke exposure among never-smoking women in Inner Mongolia, Northern China

INTRODUCTION

Currently, 40.7% of women in China are exposed daily to secondhand smoke (SHS); however, research on SHS exposure among women in Inner Mongolia is limited. We aimed to investigate the prevalence of SHS exposure, knowledge about the harms of smoking and SHS, and the association between sociodemographic factors and SHS exposure among never-smoking women in Inner Mongolia, Northern China.

METHODS

This study was based on a survey of chronic disease and nutrition conducted among Chinese adults in Inner Mongolia during 2015, a cross-sectional study with multi-stage stratified cluster sampling. A total 2293 never-smoking women aged ≥18 years were included in the study. Face-to-face interviews were used to collect data of sociodemographic characteristics, SHS exposure, and related knowledge. Questionnaires were administered by trained investigators, and the reliability and validity of the questionnaires were high. We performed descriptive analysis and logistic regression. All analyses were performed by IBM SPSS Statistics version 19.0.

RESULTS

Of the total, 69% of young women in Inner Mongolia in 2015 reported that they were exposed to SHS, the highest rate in comparison with older and middle-aged women. A total 49.90% of young women reported being exposed to SHS every day. Respondents had insufficient knowledge regarding smoking and SHS exposure. Compared with older never-smoking women, their young counterparts had a higher risk of SHS exposure, with an odds ratio of 2.143 (95% CI: 1.647–2.787). Education level and ethnicity were also significantly associated with SHS exposure.

CONCLUSIONS

This study showed that the highest rates of SHS exposure were among young never-smoking women in Inner Mongolia, and women with high education levels were less likely to be exposed to SHS. Improved public health information is needed that prioritizes SHS exposure among young women in Inner Mongolia. Health education regarding SHS exposure should be widely implemented throughout communities in this region.